Journal of Clinical Imaging Science最新文献

{"title":"Losing vigilance in diagnosing pulmonary alveolar microlithiasis: A report on four cases.","authors":"Hoang Van Luong, Lam Viet Anh, Pham Thanh Nguyen","doi":"10.25259/JCIS_56_2023","DOIUrl":"10.25259/JCIS_56_2023","url":null,"abstract":"<p><p>Pulmonary alveolar microlithiasis (PAM) is a rare chronic lung disease characterized by calcium and phosphate deposition in the alveolar lumen throughout the parenchyma of both lungs, with predominance in the middle and lower lung fields. It is caused by mutations in the recessive gene, <i>SLC34A2</i>, on the autosomal chromosome. In this article, we characterize four cases of PAM and analyze the loss of diagnostic vigilance in two of them. Patients came to medical facilities with clinical manifestations such as cough, shortness of breath, chest pain, and fatigue. The initial diagnosis was unclear in two cases because the X-ray film's quality was not good enough and the medical staff had little experience in clinical and chest X-ray interpretations for PAM. The definitive diagnosis was based on a combination of high-resolution computed tomography (CT) and bronchoalveolar lavage fluid testing. In addition, chest X-ray and high-resolution CT enable the assessment of the stage, progression, and severity of the disease. There is currently no specific treatment for PAM other than lung transplantation.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"13 ","pages":"32"},"PeriodicalIF":0.9,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10629246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71521663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Small-cell cancer of the perihilar bile duct with bleeding esophageal varices: A report of a rare case.","authors":"Ho Xuan Tuan,&nbsp;Dau Quang Lieu,&nbsp;Dao-Thi Luan,&nbsp;Nguyen Minh Duc","doi":"10.25259/JCIS_53_2023","DOIUrl":"10.25259/JCIS_53_2023","url":null,"abstract":"<p><p>Small-cell cancer is an uncommon histological subtype of neuroendocrine carcinoma. It frequently has a poor prognosis because of distant metastasis. It is diagnosed using histopathological and immunohistochemical tests. We report the case of a 29-year-old female with small-cell cancer in the perihilar bile duct who presented with bleeding esophageal varices. This case report aims to improve physicians' understanding of small-cell cancer, thereby helping to reduce the frequency of missed clinical diagnoses.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"13 ","pages":"30"},"PeriodicalIF":0.9,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a2/61/JCIS-13-30.PMC10559499.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41115433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-treatment PET/CT for p16-positive oropharynx cancer treated with definitive proton therapy.","authors":"Gregory S Alexander,&nbsp;Ariel Eve Pollock,&nbsp;Danielle Arons,&nbsp;Matthew J Ferris,&nbsp;Jason K Molitoris,&nbsp;William F Regine,&nbsp;Matthew E Witek","doi":"10.25259/JCIS_74_2023","DOIUrl":"10.25259/JCIS_74_2023","url":null,"abstract":"<p><strong>Objectives: </strong>Given emerging data suggesting that uncertainty in the relative biologic effectiveness at the distal end of the Bragg peak results in increased mucosal injury in patients with oropharynx cancer receiving adjuvant proton therapy, we evaluated the results of post-treatment positron emission tomography-computed tomography (PET/CT) in patients with p16-positive oropharynx cancer (p16+OPC) treated with definitive intensity-modulated proton therapy (IMPT).</p><p><strong>Material and methods: </strong>A retrospective cohort study of patients with p16+OPC treated with definitive IMPT between 2016 and 2022 was performed at a single institution. Patients with PET/CT scans within 6 months following completion of IMPT were included in the study. Positive post-treatment scans were defined by a maximum standard uptake values (SUVmax) >4.0 or a <65% reduction in SUVmax in either the primary tumor or lymph node. The Fisher's exact test was used to evaluate factors associated with positive post-treatment PET/ CT values.</p><p><strong>Results: </strong>Sixty-two patients were included for analysis. Median follow-up was 21 months (range: 3-71 months) with a median time to post-treatment PET/CT of 3 months (range: 2-6 months). Median post-treatment SUVmax of the primary disease and nodal disease was 0 (mean: 0.8, range: 0-7.7) and 0 (mean: 0.7, range: 0-9.5), respectively. Median post-treatment percent reduction in SUVmax for the primary site and lymph node was 100% (mean: 94%, range: 31.3-100%) and 100% (mean: 89%, range: 23-100%), respectively. Eleven patients had a positive post-treatment PET/CT with one biopsy-proven recurrence. Negative and positive predictive values (NPV and PPV) were 98% and 9.1%, respectively. There were no factors associated with positive post-treatment PET/CT.</p><p><strong>Conclusion: </strong>Similar to patients treated with photon-based radiation therapy, post-treatment PET/CT has a high NPV for patients with p16+OPC treated with definitive proton therapy and should be used to guide patient management. Additional patients and more events are needed to confirm the PPV of a post-treatment PET/CT in this favorable patient cohort.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"13 ","pages":"31"},"PeriodicalIF":0.9,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f8/1e/JCIS-13-31.PMC10559439.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41130000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypervascular nodular hepatic involvement in multiple myeloma: A case report.","authors":"Yeong Ju Han,&nbsp;Mihyun Park","doi":"10.25259/JCIS_60_2023","DOIUrl":"10.25259/JCIS_60_2023","url":null,"abstract":"<p><p>Multiple myeloma (MM) presenting as multiple hypervascular nodular hepatic infiltration is rare. We report a case of liver involvement of MM in 62-year-old woman presenting as multiple hepatic nodules with arterial enhancement and delayed washout. As in our case, the inclusion of MM in the differential diagnosis of multiple hypervascular hepatic nodules should be considered despite of its rarity.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"13 ","pages":"29"},"PeriodicalIF":0.9,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fe/8c/JCIS-13-29.PMC10559554.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41146174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality assurance for magnetic resonance angiography of the chest in patients suspected of pulmonary embolism during iodinated contrast shortage in the emergency department setting.","authors":"Anmol Singh,&nbsp;Mauricio Hernandez,&nbsp;Luis Fernando Calimano-Ramirez,&nbsp;Kazim Z Gumus,&nbsp;Wanda Marfori,&nbsp;Joanna W Kee-Sampson,&nbsp;Chandana Lall,&nbsp;Dheeraj R Gopireddy","doi":"10.25259/JCIS_3_2023","DOIUrl":"10.25259/JCIS_3_2023","url":null,"abstract":"<p><strong>Objectives: </strong>COVID-19 lockdowns resulted in a global shortage of iodinated contrast media. Therefore, alternative imaging protocols were devised to evaluate patients arriving to the emergency department (ED) with suspicion of pulmonary embolism (PE). This quality assurance (QA) aims to compare diagnostic potential between alternative magnetic resonance angiography (MRA) protocol over the gold standard computed tomography angiography (CTA) by evaluating MRA imaging quality, scanner type/imaging sequence, and any risk of misdiagnosis in patients with symptoms of PE.</p><p><strong>Material and methods: </strong>This retrospective study compromised of 55 patients who arrived to ED and underwent MRA of the chest for suspicion of PE during the months of May to June 2022. Data regarding their chief complaints, imaging sequence, and MRA results were collected. Two fellowship-trained faculty radiologists reviewed the MRA scans of the patients and scored the quality using a Likert scale.</p><p><strong>Results: </strong>Two patients were positive for PE and 53 patients showed negative results. Regarding the scan quality issues, motion was noted in 80% of the 55 studies that we reviewed. Significant associations (<i>P</i> < 0.009) between Likert scale scores and initial complaint category were found. The characteristic symptoms associated with suspicion of PE, namely, shortness of breath, chest pain, and cough were distributed among the 1 and 2 categories, reflecting the most optimal vessel opacification scores. We found no risk of misdiagnosis after reviewing the electronic medical record for follow-up appointments within 6 months of ED visit.</p><p><strong>Conclusion: </strong>Patients were screened for PE with MRA as an alternative imaging tool during times of contrast shortage. Further, evaluation of MRA with CTA, side by side, in a larger patient population is required to increase the validity of our QA study.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"13 ","pages":"28"},"PeriodicalIF":0.9,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ea/93/JCIS-13-28.PMC10559390.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41134120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral stent-graft for the management of an ulnar artery pseudoaneurysm.","authors":"Shivam Khatri,&nbsp;Steven Epstein,&nbsp;Simon Kashfi","doi":"10.25259/JCIS_80_2023","DOIUrl":"10.25259/JCIS_80_2023","url":null,"abstract":"<p><p>Penetrating injury can cause pseudoaneurysm which can then affect nerve compression. Although rare, penetrating injuries leading to ulnar artery pseudoaneurysm (UAP) are implicated slightly more frequently than other upper extremity arterial segments. Manual compression, thrombin injections, and surgical reconstruction are typically chosen to effect repair. Conversely, peripheral stent-graft implantation has rarely been reported as an option to exclude upper extremity pseudoaneurysm. We describe a case of a 25-year-old male who was stabbed, presented with signs of ulnar nerve compression, and in whom UAP was instead discovered and treated by stent-graft deployment.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"13 ","pages":"27"},"PeriodicalIF":0.9,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/39/10/JCIS-13-27.PMC10559374.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41118236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications with the use of Angio-Seal vascular closure device and their management.","authors":"Mohd Shariq,&nbsp;Krishna Prasad Bellam Premnath,&nbsp;Ahmed Tarek Saleh,&nbsp;Julian Coker","doi":"10.25259/JCIS_68_2023","DOIUrl":"10.25259/JCIS_68_2023","url":null,"abstract":"<p><p>Vascular closure devices (VCDs) are being increasingly used for achieving hemostasis after diagnostic and therapeutic endovascular procedures. Although uncommon, complications may be encountered which are associated with the use of these VCDs. We report four cases where the use of Angio-Seal (Terumo, Somerset, New Jersey, USA) was followed by complications. Three cases presented with acute limb ischemia, among them, two patients had arterial occlusion at the vascular access site and one patient had embolization of the footplate anchor of the closure device. One case presented with pseudoaneurysm at the common femoral artery access site along with occlusion at origin of the superficial femoral artery. We have described the mechanism in which these complications occur and the successful management of these cases preventing potential amputation and limb loss. The risk factors which increase the risk of complications with the use of Angio-Seal VCD were reviewed and the strategy to avoid these complications with particular emphasis on the utility of ultrasound when using Angio-Seal VCD is discussed. A strategy to manage these complications has been discussed while deciding on endovascular management or surgical management, especially in patients with challenging presentation and those with multiple comorbidities making them at very high risk for surgery.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"13 ","pages":"26"},"PeriodicalIF":0.9,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/71/10/JCIS-13-26.PMC10559466.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41115432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison of balloon-assisted versus dilator in percutaneous gastrostomy tube placement.","authors":"Sean Lee,&nbsp;Abheek Ghosh,&nbsp;Aislynn Raymond,&nbsp;Nabeel M Akhter","doi":"10.25259/JCIS_55_2023","DOIUrl":"10.25259/JCIS_55_2023","url":null,"abstract":"<p><strong>Objectives: </strong>This study assesses the safety and efficacy of balloon-assisted gastrostomy (BAG) compared to conventional techniques using dilators.</p><p><strong>Material and methods: </strong>A single-center retrospective review of all fluoroscopically-guided percutaneous gastrostomy tube insertions from July 2017 to September 2020 was performed. Two hundred and seventy-three patients were included in this study, with 183 patients and 90 patients in the BAG and dilator groups, respectively. Fluoroscopy time, peak radiation dose, pain management, days to interventional radiology (IR) reconsultation, and post-operative complications (major and minor) for each procedure were reviewed to evaluate for statistical differences.</p><p><strong>Results: </strong>There were shorter fluoroscopy times (5.13 min vs. 7.05 min, <i>P</i> = 0.059) and a significantly lower radiation use (Avg = 102.13 mGy vs. 146.98 mGy, <i>P</i> < 0.05) in the BAG group. The BAG group required significantly lower operating time (41 min vs. 48 min, <i>P</i> < 0.01) and received lower pain management (fentanyl 75 mcg and midazolam 1.5 mg, <i>P</i> < 0.001). The mean days to IR reconsultation for the BAG group was greater (29 days vs. 26 days, <i>P</i> = 0.38). The overall rate of minor complications (grades 1 and 2, according to the CIRSE classification system) was higher in the dilator group (39% vs. 35% in BAG group, <i>P</i> = 0.53). No major complications were reported in either group.</p><p><strong>Conclusion: </strong>BAG is a safe and efficient technique for percutaneous gastrostomy tube placement. BAG patients required significantly lesser radiation, OR time, post-operative pain management, and recorded lower postoperative complications compared to their counterparts in gastrostomies utilizing dilators.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"13 ","pages":"25"},"PeriodicalIF":0.9,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2e/06/JCIS-13-25.PMC10559364.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41128267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging of penetrating vascular trauma of the body and extremities secondary to ballistic and stab wounds.","authors":"Dheeraj Reddy Gopireddy, Joanna W Kee-Sampson, Sai Swarupa Reddy Vulasala, Rachel Stein, Sindhu Kumar, Mayur Virarkar","doi":"10.25259/JCIS_99_2022","DOIUrl":"10.25259/JCIS_99_2022","url":null,"abstract":"<p><p>In the United States, gunshot wounds (GSWs) have become a critical public health concern with substantial annual morbidity, disability, and mortality. Vascular injuries associated with GSW may pose a clinical challenge to the physicians in the emergency department. Patients demonstrating hard signs require immediate intervention, whereas patients with soft signs can undergo further diagnostic testing for better injury delineation. Although digital subtraction angiography is the gold standard modality to assess vascular injuries, non-invasive techniques such as Doppler ultrasound, computed tomography angiography, and magnetic resonance angiography have evolved as appropriate alternatives. This article discusses penetrating bodily vascular injuries, specifically ballistic and stab wounds, and the corresponding radiological presentations.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"13 ","pages":"1"},"PeriodicalIF":1.1,"publicationDate":"2023-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/25/66/JCIS-13-1.PMC9899476.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9244000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metrics-driven successful strategy by emergency and radiology driven task force to mitigate global CT contrast media shortage in a safety net hospital.","authors":"Dheeraj Reddy Gopireddy,&nbsp;Mayur Virarkar,&nbsp;Sai Swarupa Reddy Vulasala,&nbsp;David Caro,&nbsp;Ashley Norse,&nbsp;Dinesh Rao","doi":"10.25259/JCIS_116_2022","DOIUrl":"https://doi.org/10.25259/JCIS_116_2022","url":null,"abstract":"<p><p>Iodinated contrast media (ICM) shortages and secondary supply chain problems due to Coronavirus Disease lockdowns in China significantly impacted radiology operations nationwide. The lack of ICM necessitated operational workflow changes designed to ration contrast use, particularly in the hospital setting. In this manuscript, we share our strategic methods with advanced process/outcome metrics to monitor the effectiveness of our strategy under a coordinated multidisciplinary team effort. Alternate studies such as substituting magnetic resonance angiography for computed tomographic angiography for emergency department patients were studied to measure the suitability of these examinations for specific diagnoses. This article presents readers with a comprehensive crisis management strategy deployed at our institution, emphasizing various options with a limited ICM supply, and minimizing the impact on clinical care.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"13 ","pages":"2"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b6/31/JCIS-13-2.PMC9899449.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9243998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}